Healthcare Provider Details
I. General information
NPI: 1346464161
Provider Name (Legal Business Name): RHOBELLIE FLORENDO WILSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/12/2007
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1738 CHURN CREEK RD
REDDING CA
96002-0236
US
IV. Provider business mailing address
4451 RISSTAY WAY
SHASTA LAKE CA
96019-2352
US
V. Phone/Fax
- Phone: 530-709-1080
- Fax:
- Phone: 530-524-6286
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT28536 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: